Background: Use of insulin pens is common among people with diabetes. Print instructions contain a disclaimer that pens are "not recommended for the blind or visually impaired without the assistance of a sighted individual" and nonvisual instructions are unavailable. No published evidence exists supporting or refuting the disclaimer, though many blind people do use insulin pens. Ethical norms and federal law require health professionals to provide equal access for people with disabilities. Excluding people with disabilities from using a common self-management device without evidence of inability to use it cannot be considered ethical. This study is phase one of gathering evidence to support or refute this exclusion. Conceptual Framework: The study was guided by the Chronic Care Model, by Wagner et al. Research Questions: The study had 3 questions: (1) What makes audio insulin pen instructions effective for blind people? (2) Is dosing accuracy measured with reliably by weighing doses delivered into a cup? (3) Is there adequate preliminary data about accuracy of doses delivered by blind people using an insulin pen to proceed with a larger study? Methods: Twelve blind individuals with no manual dexterity or memory problems listened to a recording of instructions for an insulin pen, including verbal description of pictures and nonvisual techniques for visual tasks, while handling the pen and supplies. Participants gave feedback on the clarity of the instructions and possible improvements. They then delivered 3 different doses of insulin 2 times each in random order. The doses were weighed using a precise scale. Results: Participants offered numerous suggestions for improving the audio instructions, such as verbal "framing" equivalent to visual layout, and specific nonvisual techniques. Dose delivery into a small cup introduced an artificial inaccuracy, a "hanging drop" on the end of the insulin needle. Excluding these, all 12 participants were able to dial and deliver 6 doses each with less than 10% error. Conclusions: Effective audio instructions should include verbal "framing" and nonvisual techniques. Insulin dose accuracy is not adequately measured by weighing insulin delivered into a cup. The dose accuracy data was sufficient to proceed with a larger study.

Full metadata record

DC Field

Value

Language

dc.type

Presentation

en_GB

dc.title

Use of Insulin Pens By Blind People: A Feasibility Study

en_GB

dc.identifier.uri

http://hdl.handle.net/10755/158437

-

dc.description.abstract

<table><tr><td colspan="2" class="item-title">Use of Insulin Pens By Blind People: A Feasibility Study</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Williams, Ann, PhD, RN, CDE</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Case Western Reserve University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">10900 Euclid Avenue, Cleveland, OH, 44106, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">216-368-1704</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">asw13@case.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">A.S. Williams, Nursing, CWRU, Cleveland, OH;</td></tr><tr><td colspan="2" class="item-abstract">Background: Use of insulin pens is common among people with diabetes. Print instructions contain a disclaimer that pens are &quot;not recommended for the blind or visually impaired without the assistance of a sighted individual&quot; and nonvisual instructions are unavailable. No published evidence exists supporting or refuting the disclaimer, though many blind people do use insulin pens. Ethical norms and federal law require health professionals to provide equal access for people with disabilities. Excluding people with disabilities from using a common self-management device without evidence of inability to use it cannot be considered ethical. This study is phase one of gathering evidence to support or refute this exclusion. Conceptual Framework: The study was guided by the Chronic Care Model, by Wagner et al. Research Questions: The study had 3 questions: (1) What makes audio insulin pen instructions effective for blind people? (2) Is dosing accuracy measured with reliably by weighing doses delivered into a cup? (3) Is there adequate preliminary data about accuracy of doses delivered by blind people using an insulin pen to proceed with a larger study? Methods: Twelve blind individuals with no manual dexterity or memory problems listened to a recording of instructions for an insulin pen, including verbal description of pictures and nonvisual techniques for visual tasks, while handling the pen and supplies. Participants gave feedback on the clarity of the instructions and possible improvements. They then delivered 3 different doses of insulin 2 times each in random order. The doses were weighed using a precise scale. Results: Participants offered numerous suggestions for improving the audio instructions, such as verbal &quot;framing&quot; equivalent to visual layout, and specific nonvisual techniques. Dose delivery into a small cup introduced an artificial inaccuracy, a &quot;hanging drop&quot; on the end of the insulin needle. Excluding these, all 12 participants were able to dial and deliver 6 doses each with less than 10% error. Conclusions: Effective audio instructions should include verbal &quot;framing&quot; and nonvisual techniques. Insulin dose accuracy is not adequately measured by weighing insulin delivered into a cup. The dose accuracy data was sufficient to proceed with a larger study.</td></tr></table>

en_GB

dc.date.available

2011-10-26T21:03:09Z

-

dc.date.issued

2011-10-17

en_GB

dc.date.accessioned

2011-10-26T21:03:09Z

-

dc.description.sponsorship

Midwest Nursing Research Society

en_GB

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